Magnesium

The benefits of the humble mineral magnesium are so numerous and dramatic that, if it were an expensive drug, it’d be the buzz at every party and every doctor would prescribe it. Magnesium is used in at least 300 enzyme systems that run the body’s moment to moment operations, so it’s really hard to overstate its importance for health in general1 and heart health in particular2. For example, a recent study showed that the more magnesium subjects took in, the less calcification of arteries they showed. (“Magnesium Intake Is Inversely Associated With Coronary Artery Calcification: The Framingham Heart Study.” JACC Cardiovasc Imaging. 2013 Nov 20.) What drug at any price can do all the jobs below which are achieved with simply an adequate body level of magnesium?

REDUCED:

Blood pressure (it’s nature’s calcium channel blocker)3

Blood stickiness4

Triglycerides and LDL5

Inflammation6

INCREASED:

HDL (the “good” cholesterol)7

Bone density8

Bowel regularity9

Resistance to infection10

MAGNESIUM INSUFFICIENCY ASSOCIATED WITH:Note: Although I’ve included references for some of the following, much of the work done on these magnesium connections was completed many years ago and is now considered common knowledge. Some other associations are not yet “proven” but preliminary science and the basic way magnesium works make them seem very likely. Nutritionists and doctors of natural medicine see great clinical benefit using magnesium with patients. We need to share this information with mainstream medical practitioners.

Oh and one other little thing—sudden death from cardiac spasm and altered heart rhythms. Magnesium is being studied for benefit with traumatic brain injury30, reducing neuropathy from chemotherapy31 and hearing damage as well as many other potential uses.32 More study should be done on the role of magnesium in detoxification of chemicals because practitioners find it helps—i.e. for those who react strongly to “sick building syndrome” and other chemicals.

If you hear of a pharmaceutical drug that can do half of that list with little to no side effects, buy lots of stock in that company! Crucial as it is, it’s likely that neither you nor your doctor have heard much about magnesium because it is inexpensive and cannot be patented. That removes the economic incentive that drives most research, medical education and media coverage.

HOW IT WORKSSomething with so many positive effects may at first sound unbelievable. But it is easy to understand why magnesium has such a wide variety of effects since it participates in so many basic and critical functions. Here are just a few examples:

Duplication and repair of DNA (low mag leads to genetic errors setting us up for cancer)

Energy – it’s crucial to carbohydrate metabolism and the production and storage of energy inside cells

Gatekeeper – assuring that minerals such as potassium, sodium and calcium are kept inside or outside of cells wherever they belong.

Oxygen – helps the blood pick up oxygen so it can carry it to where it is needed

Soft tissue calcification – blocks calcium from going where it can cause trouble

I put those in alphabetical rather than priority order because we can’t do without any of them. The cells that contain the highest levels of magnesium are the ones with the greatest metabolic activity—the heart, liver, brain and kidney.

DEFICIENCYSurely you can now see why it would be a very big problem if Americans were low in magnesium. Oops, they are low! Two large prestigious studies (NHANES III and CSF II) showed that we take in only 70% of even the modest government-recommended amount. Our farm soils are depleted of magnesium and artificial fertilizers further reduce the amount that crops take up. That makes organic foods a better choice.33 Drinking water should be a source, but the water in some areas contains little and we make matters worse by using filters that remove minerals (not all do) and by drinking bottled water.

The biggest problem is that we don’t eat enough of the foods like dark green leafy vegetables, beans, nuts seafood, figs, and apples that are rich in magnesium. And we eat too much of those from which the magnesium has been refined out (like white flour and sugary products). Worse yet, our bodies need additional magnesium just to process those refined foods. When whole grain wheat is turned into white flour or brown rice is made into white, approximately 80% of the magnesium is removed. To make what is laughably called “enriched” flour, a few nutrients are added back…but surprise, surprise magnesium is not one of them. Improper cooking methods leach out more magnesium into the cooking water.

It may be no coincidence that the elderly, who suffer most from the conditions listed above, get the least magnesium—probably because they eat a smaller quantity of food, too often resort to convenient packaged foods, take magnesium-depleting drugs and have reduced efficiency of intestinal absorption.

MAG HELPERSVitamin D, the sunshine vitamin, improves the absorption and retention of magnesium just as it does calcium. That is just one of the dozens (perhaps hundreds) of reasons to make sure you have sufficient blood levels of vitamin D. Stomach acid helps. (So, except in rare cases, blocking stomach acid is a bad idea.)

The mineral selenium and Vitamin B 6 also help absorption.

MAG BLOCKERSThe following factors increase our need for magnesium, cause us to dump it, slow its absorption and/or interfere with our ability to use it:

Acid-blocking drugs used for heartburn and acid reflux. (My book on the topic notes that there is even an FDA warning on the package about this effect.)

Acidic tissues (e.g. due to refined foods & sodas)

Aging

Alcoholism

Calcium excess

Coffee

Diabetes

Diarrhea

Dieting

Dysbiosis*

Excess fiber (phytates bind it)

Heavy menstrual flow

High carbohydrate diets

Low thyroid levels

Oxalates (e.g. in spinach, chocolate)

Pinworms and other parasites

Protein imbalance.

Salt excess

Soda pop

Stress (physical or emotional)

Sweating

*That’s an imbalance in the gut of bad bacteria and yeasts versus friendly bacteria called “probiotics”.

Calcium: We constantly hear about calcium for stronger bones because that is one of the very few “health claims” allowed by the US FDA and manufacturers use it liberally. However, magnesium is just as important to building bone and without it calcium may end up as a kidney stone, a bone spur or worse. Excess calcium inhibits absorption of magnesium.

The natural diet our hunter-gatherer ancestors ate was very high in magnesium and low in calcium. Therefore, our systems are adapted to be efficient at absorbing calcium but not necessarily quick to pick up magnesium. Obviously we’ve short-circuited the original system by avoiding the natural food sources of magnesium and meanwhile too often supplementing calcium by itself. Calcium is also being added in many surprising places like orange juice.

For strong bones, young people should take care to get enough calcium but also sources of magnesium, vitamin D and the other nutrients needed to assure that calcium is incorporated into bone. BoneUp by Jarrow is an example of a comprehensive and balanced bone formula great for adults. After menopause, lack of estrogen becomes a big factor. Resveratrol in Longevinex and the lignans in sprouted flax help with that.

BALANCE IS CRUCIALBecause nutrients work together in complex systems, when we eliminate one nutritional element in our diet or get carried away with another (e.g. calcium above), trouble almost always follows. For example:

Fat: if we consume too much fat (along with too many calories) we gain weight and we don’t absorb as much magnesium. On the other hand, if there is too little fat in our diet we can be hungry all the time and can’t make hormones normally and that might ultimately lower magnesium too.

Protein: Eating too little protein interferes with magnesium absorption but eating too much increases magnesium excretion. If you can’t get it right, err on the side of getting too much protein because the body adapts better to that than to inadequate intake.

Salt: Too much salt (sodium chloride) reduces absorption. But if you severely restricted salt, you might not have the chloride part of salt needed to make stomach acid, which in turn helps magnesium absorption.

TESTINGIt sure would be nice if we had a common test to tell if our body has sufficient magnesium. Tests of blood serum magnesium are often used but don’t tell us much.34 That’s because over half the magnesium in the body is stored in bones and as noted above most of the rest is in tissues not the fluid part (serum) of blood. If your serum is low you are in real trouble, but a “normal” reading doesn’t mean you are good. A nutritionist can perform a “loading test” to see how much is excreted versus stored. However, the best test you might be able to order more easily is “red blood cell magnesium.” (If you have an underactive thyroid the blood test result level could be artificially high because magnesium is being lost from tissues and is on its way out.)

SUPPLEMENTSAs with any nutrient, it would be ideal if we could get all we need from food, but that clearly isn’t happening. The least expensive form of magnesium is “oxide”, so that’s why you usually find it in multi-vitamins and budget brands. Magnesium oxide is more likely to have a laxative effect which, while appreciated by some, is likely an indicator that not much is getting utilized by the cells. Magnesium “citrate” is a little better absorbed and gentler—it would be fine for normal supplementation for most people. With our sponsor HealthWorksMart.com’s HealthWorks Magnesium Citrate, you could take 200 mg for less than a nickle a day! However, for those who need to solve a problem by improving cellular magnesium levels, products that are chelated or that combine specialized magnesium forms are likely to be more effective. Suzy Cohen’s Magnesium is a good example. Using a liquid on the skin is another option, especially useful if you have muscle pain or cramping or get a loose stool from other types (see more below). To target brain health and memory, there is a cost effective tasty brain mag powder by Suzy Cohen.

Topical: An Epson salts bath has long been used for relaxation and other health benefits because it allows absorption of magnesium through the skin. Milk of Magnesia isn’t good as a supplement, but from anecdotal reports, it seems to help acne when dabbed on the skin with a cotton wad and can be used as a deodorant. A convenient topical form sold by one of our sponsors allows you to supplement magnesium without creating a loose stool. Magnesium oil isn’t really oil but has the feel of oil until it dries. One thing I appreciate about this product besides being able to put it right where you need it, it’s one less pill to swallow.

DOSENot one of us is“average” because we are biochemically unique, but just as a guide, many nutritionists recommend supplementing at 100-700 mg a day. Ideally we’d all get a red blood cell magnesium test and see if our levels are sufficient. But, if you are winging it, start by looking at the amount of magnesium rich foods in your diet and see how many of the magnesium blockers might be affecting you. The acid-blocking heartburn medicines interfere with magnesium absorption in a big way.

If you have several health issues related to low magnesium or if you are an athlete, you might target the higher side of the range . Be sure to add in the amount in your multi vitamin, multi-mineral and bone formulas. When you first start supplementing, use a small amount and build. At the point your stool becomes too soft, back off. But, remember that a loose stool doesn’t necessarily mean you have enough inside your cells; it is just a measure of how much your gut can tolerate.

Deficiency of magnesium may be a factor in causing kidney disease. However, once a person has kidney disease, he or she must check with their physician because the kidneys may not be able to handle a magnesium supplement. (Maybe the doctor would allow some topical magnesium.)

WHEN WILL YOU SEE RESULTS?For something like monthly cramps, magnesium will bring almost instant relief. It also acts quickly for relaxation. But if you have been low for a long time, it may take weeks or even months for magnesium to get into all the cells that need it because the mineral may have to evict a toxin that has moved into its rightful spot.

SAFETYThis is a nutrient required for life itself, so toxicity is rare. However, you can overdo anything.

MAGNESIUM AND MEDICATIONSMany drugs like acid-blockers, diuretics, digitalis (digoxin), insulin and some antibiotics interfere with magnesium and lower its levels. Often this is a double whammy—people taking these drugs most likely already needed higher levels of magnesium. It’s also interesting that potassium is given to make up for what’s lost from diuretic use. However, it can be difficult to get the potassium levels back to normal without also supplementing magnesium. That is due in part to the fact magnesium has also been flushed out by the diuretic. Drugs for heartburn and acid reflux interfere with magnesium by reducing stomach acid.

Magnesium can attach to the antibiotic tetracycline and other antibiotics reducing their effect. So magnesium should not be taken too close to the time the drug is taken. The same applies to thyroid medication and many other drugs. Allow 2-3 hours between the two. Again, my little ole book will help folks find alternatives.

Because of the therapeutic effect of magnesium, it would be wise to watch closely for the combined effects of magnesium and the drugs you take. For example, magnesium by itself will not lower blood pressure below normal, but a drug might. Therefore, when you get your magnesium level up to normal, you may need a lower dose of blood pressure medication. The same might be true of meds for depression, sleep, cholesterol, diabetes, high blood pressure, asthma and other conditions. Likewise, you might need less of natural remedies such as l-tryptophan, melatonin and St. John’s Wort. When in doubt, consult your doctor.

SUMMARY RECOMMENDATIONSI love this quote attributed to Mary Ann Block, MD: “First do no harm. Second, use magnesium.” Magnesium is so critical for health that we ignore it at our peril. I believe we would solve the healthcare crisis if people just ate fewer refined foods and got sufficient magnesium, vitamin D, probiotics, and fish oil.

Eat foods that are naturally high in magnesium and avoid factors that interfere with magnesium. If you have some of the problems listed above, perhaps try a supplement. Even a fairly subtle insufficiency can lead to pain, suffering and an early death. Don’t assume if someone is in the hospital, even for a heart attack, that the staff will think to look at the magnesium levels. Please ask.

RESOURCESThis information is educational only and is not intended to replace the advice of a healthcare professional. The statements have not been evaluated by the FDA . Any products mentioned are not allowed to be nor are intended to diagnose, treat, cure, or prevent any disease. Consult with a health profession who knows nutrition regarding any illness.

Radio: Archived interview with Dennis Goodman, MD. In the show he talked about how the inexpensive mineral magnesium can help with blood pressure, cramping of all kinds, sleeplessness, osteoporosis and much more. He cited the Nurses’ Health Study that showed dramatic reduction in the risk of sudden cardiac death with higher blood levels of magnesium. LINK.

Aging is very often associated with magnesium (Mg) deficit. Total plasma magnesium concentrations are remarkably constant in healthy subjects throughout life, while total body Mg and Mg in the intracellular compartment tend to decrease with age. Dietary Mg deficiencies are common in the elderly population. Other frequent causes of Mg deficits in the elderly include reduced Mg intestinal absorption, reduced Mg bone stores, and excess urinary loss. Secondary Mg deficit in aging may result from different conditions and diseases often observed in the elderly (i.e. insulin resistance and/or type 2 diabetes mellitus) and drugs (i.e. use of hypermagnesuric diuretics). Chronic Mg deficits have been linked to an increased risk of numerous preclinical and clinical outcomes, mostly observed in the elderly population, including hypertension, stroke, atherosclerosis, ischemic heart disease, cardiac arrhythmias, glucose intolerance, insulin resistance, type 2 diabetes mellitus, endothelial dysfunction, vascular remodeling, alterations in lipid metabolism, platelet aggregation/thrombosis, inflammation, oxidative stress, cardiovascular mortality, asthma, chronic fatigue, as well as depression and other neuropsychiatric disorders. Both aging and Mg deficiency have been associated to excessive production of oxygen-derived free radicals and low-grade inflammation. Chronic inflammation and oxidative stress are also present in several age-related diseases, such as many vascular and metabolic conditions, as well as frailty, muscle loss and sarcopenia, and altered immune responses, among others. Mg deficit associated to aging may be at least one of the pathophysiological links that may help to explain the interactions between inflammation and oxidative stress with the aging process and many age-related diseases.

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